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Eur J Cardiothorac Surg 2003;24:187-191
© 2003 Elsevier Science NL

Maximal thymectomy in children with myasthenia gravis

^a Thoracic Surgery Unit, Department of Surgery, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh 11472, Saudi Arabia
^b King Faisal Specialist Hospital, Riyadh, Saudi Arabia
^c Pediatric Neurology Unit, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

Received 28 September 2002; received in revised form 21 April 2003; accepted 26 April 2003.

^* Corresponding author. Tel.: +966-1-467-1920; fax: +966-1-467-9493
e-mail: alkattan{at}ksu.edu.sa

Objectives: We performed this study to evaluate the benefit of thymectomy in children with myasthenia gravis (MG). Methods: Over a period of 15 years from 1986 to 2001, we collected data on 30 children with MG and retrospectively reviewed the outcome of maximal thymectomy. Results: There were 23 females and seven males with a mean age of 13.2 years (range 4–16). The mean duration of the disease was 19.3 months (range 2–144). According to Osserman classification, there were 14 children in class II; 12 in class III; and four children in class IV. One child in class IV required postoperative ventilation and one was re-explored to drain a pericardial effusion secondary to central line leak. We found ectopic thymic tissue in 10 cases (33.3%). During a mean follow-up period of 53.5 months (range 9–180), complete remission was noted in 13 children (43.4%) and improvement in 14 (46.6%). The remaining three children (10%) did not improve following surgery. Univariate analysis (P<0.05) showed that ectopic thymic tissue is a significant prognostic factor for outcome. Conclusion: Maximal thymectomy appears to provide a high rate of remission and improvement in children with MG. However, the presence of ectopic thymic tissue has poor prognostic value.

Key Words: Myasthenia gravis • Maximal thymectomy • Children

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